"Standard Compromise Order Form" - Bronx County, New York

Standard Compromise Order Form is a legal document that was released by the New York Supreme Court - a government authority operating within New York. The form may be used strictly within Bronx County.

Form Details:

  • The latest edition currently provided by the New York Supreme Court;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the New York Supreme Court.

ADVERTISEMENT
ADVERTISEMENT

Download "Standard Compromise Order Form" - Bronx County, New York

Download PDF

Fill PDF online

Rate (4.8 / 5) 13 votes
Page background image
FORM - STANDARD COMPROMISE ORDER
At an IAS Part ______of the Supreme Court of
The State of New York, held in and for the
County of Bronx, at the Courthouse thereof, located
at 851 Grand Concourse, on the ____ day of
_________________, 200__.
Present: Hon. Paul A. Victor, J.S.C.
________________________________________x
Index No. _____________
Infants Compromise Order
Plaintiff(s),
-against-
Defendant(s).
________________________________________x
Upon reading and filing the petition of _______________________________, parent
and natural guardian of the infant herein, duly sworn to the ____ day of _________, 200__;
the affidavit of ____________________________, the infant plaintiff who is over the age of 14,
having been born on ________________; the affirmation of __________________________
_________________________, attorney(s) for plaintiff(s), dated the _____ day of ______________,
200 __; the affirmation of __________________________, M.D. dated the ___day of
______________, 200___; and the aforesaid mother and natural guardian, and the infant plaintiff, and
their attorney having appeared before me on the _______ day of __________________,200__; and
upon all of the papers, pleadings and proceedings heretofore had herein; and it appearing that the best
interests of the infant will be served by approval of this settlement;
NOW, on motion of plaintiffs attorneys, it is
FORM - STANDARD COMPROMISE ORDER
At an IAS Part ______of the Supreme Court of
The State of New York, held in and for the
County of Bronx, at the Courthouse thereof, located
at 851 Grand Concourse, on the ____ day of
_________________, 200__.
Present: Hon. Paul A. Victor, J.S.C.
________________________________________x
Index No. _____________
Infants Compromise Order
Plaintiff(s),
-against-
Defendant(s).
________________________________________x
Upon reading and filing the petition of _______________________________, parent
and natural guardian of the infant herein, duly sworn to the ____ day of _________, 200__;
the affidavit of ____________________________, the infant plaintiff who is over the age of 14,
having been born on ________________; the affirmation of __________________________
_________________________, attorney(s) for plaintiff(s), dated the _____ day of ______________,
200 __; the affirmation of __________________________, M.D. dated the ___day of
______________, 200___; and the aforesaid mother and natural guardian, and the infant plaintiff, and
their attorney having appeared before me on the _______ day of __________________,200__; and
upon all of the papers, pleadings and proceedings heretofore had herein; and it appearing that the best
interests of the infant will be served by approval of this settlement;
NOW, on motion of plaintiffs attorneys, it is
1
1. ORDERED , that the aforesaid parent and natural guardian of the infant plaintiff, be
and hereby is authorized and empowered to settle the action against the defendant(s)for the sum of
________________________ ($___________) dollars; and it is further ordered that the aforesaid
sum shall be apportioned and paid by defendant(s) as follows:
(A)
The sum of $_______________ shall be paid by the defendant(s) ________________
_________________________ or its/their insurer as hereinafter provided; and
(B)
The sum of $_______________ shall be paid by the defendant(s) ________________
_______________________________ or its/their insurer, as hereinafter provided; and
2. ORDERED that the aforesaid defendant, (identified in 1A above) or its/their insurer pay the
aforesaid settlement sum as follows:
(A)
The sum of ($__________) to the order of the above named attorneys for the plaintiff as and
for attorneys’ fees, inclusive of all disbursements and expenditures made on plaintiff’s
behalf; and
(B)
The sum of ($___________) to the order of _____________________, in full satisfaction
of the outstanding lien for services rendered and/or money advanced to said plaintiff; and
(C)
The sum of ($ __________) to the aforesaid parent and natural guardian
of the said infant, jointly with an officer of the ______________________ Bank, located at
________________________________________________, said funds
to be deposited in said Bank and held therein for the sole use and benefit of said infant,
subject to the further order of this Court; and
2
(D)
The sum of ($ __________) to the aforesaid parent and natural guardian
of the said infant, jointly with an officer of the ____________________________ Bank,
located at ____________________________________________________, said funds to be
deposited in said Bank and held therein for the sole use and benefit of said infant, subject to
the further order of this Court; and
and it is further
1
Paragraphs numbered 1, 2 and 3 are designed for settlements where there are two
defendants contributing to the settlement. If there are more than, or less than, two defendants,
the number of paragraphs and/or sub-paragraphs should be modified to equal the number of
contributing defendants. Superfluous paragraphs should be omitted.
2
If the total sum to be received by the infant does not exceed the then prevailing Federal
Deposit Insurance Corporation limits, paragraphs 2(D), 3 (C) and 3A(D) can be omitted.
(3) ORDERED that the aforesaid defendant(s), (identified in 1B above) or its/their insurer pay the
aforesaid settlement sum as follows:
(A)
The sum of ($__________) to the order of the above named attorney’s for the plaintiff as and
for attorneys’ fees, inclusive of all disbursements and expenditures made on plaintiff’s
behalf; and
(B)
The sum of ($__________) to the order of_______________________________, in full
satisfaction of the outstanding lien for services rendered and/or money advanced to said
plaintiff; and
(C)
The sum of ($ __________) to the aforesaid parent and natural guardian of the said infant,
jointly with an officer of the ______________________Bank, located
at ____________________________________________________, said funds to be
deposited in said Bank and held therein for the sole use and benefit of said infant, subject to
the further order of this Court; and
(D)
The sum of ($ __________) to the aforesaid parent and natural guardian of the said infant,
jointly with an officer of the __________________________________
Bank, located at ______________________________________________, said funds
to be deposited in said Bank and held therein for the sole use and benefit of said infant,
subject to the further order of this Court; and
and it is further
(4) ORDERED, that upon full payment of all of the aforesaid amounts, defendant(s) and its (their)
insurer(s) shall have no further liability herein; and it is further
(5) ORDERED, that the funds deposited in (each) said Bank shall be held therein for the sole
use and benefit of said infant, subject to the further order of this Court.; and it is further
(6) ORDERED, that (each) said Bank shall place these funds in the highest interest bearing
time accounts or certificates of deposit, and said certificates and accounts shall be renewed upon
maturity, provided, however, the maturity date of such certificates and accounts or any renewal thereof,
th
shall not extend beyond the date of the infant’s eighteenth (18 ) birthday; and it is further
(7) ORDERED, that the attorney for the plaintiffs shall serve a copy of this Order upon (each)
said Bank and shall arrange for the deposit of said funds as expeditiously as is reasonably possible; and
it is further
(8) ORDERED, that within thirty (30) days of the deposit of said funds in the above-designated
bank(s) the above guardian shall submit to the Clerk’s Office, Room 217, a copy of the certificate of
deposit(s) issued by said bank(s); and there shall be no right of withdrawal from any of the aforesaid
account(s) and certificates of deposit until the infant plaintiff’s eighteenth (18th) birthday, except upon
further order of this Court, which said Order shall be certified by the Clerk of this Court; and it is further
(9) ORDERED, that in the event that the balance of the aforesaid account(s) and/or certificates
exceeds the then prevailing Federal Department Insurance Corporation limits, the officer-trustee of said
Bank and the infant’s guardian herein are directed to notify the Court so that a further designation of an
individual depository may be made in order to keep the balance of each such account and certificate
within federally insured limits; and it is further
(10) ORDERED, that (each) Bank shall pay over all monies held in the aforesaid certificates
and accounts to the infant plaintiff herein upon demand and without further Court order when the infant
reaches the age of eighteen (18) years upon presentation of proper proof and compliance with the Bank
rules of withdrawal; and it is further
(11) ORDERED, that each year (or quarterly as the case may be) during the minority of the
infant plaintiff, upon presentation to the above named Bank of a duly executed income tax return or other
document showing the amount of income or estimated tax due on behalf of the infant, said Bank shall
provide the infant’s guardian herein with checks made payable to the Internal Revenue Service and/or
State and/or Municipal Taxing Authority to which said income tax is owed by said infant. However,
said checks shall be only for such amounts as may be due and payable for that portion of the infant’s
personal income tax liability attributable to income earned on said accounts [including interest and
penalties thereon] as shown on any official bill therefor issued by the taxing authority. Said check and/or
checks shall identify the infant and said infants social security number in order to insure that said
amounts are being made for the benefit of the infant; and it is further
(12) ORDERED, that said banks be and hereby are authorized without further order of this court
to pay out of the infant’s bank accounts, reasonable fees for the preparation of any income tax, return
or estimated income tax return or accounting that may be required to be filed by or on the infant’s behalf.
Said fees shall not exceed $ _________ without the further order of the Court; and it is further
th
(13) ORDERED, that in the event of the death of said infant plaintiff on or prior to the 18
birth date of said infant, all of the aforesaid sums described in (each) said Bank shall be paid to the
estate of said infant plaintiff, or to the designated beneficiary of said estate in the same amount and in
the same manner as hereinbefore set forth; and it is further
(14) ORDERED, that the cause of action for loss of services and/or medical expenses of the
guardian be and the same hereby is dismissed without costs and with prejudice; and it is further
(15) ORDERED, that conditioned upon compliance with the terms of this order, the aforesaid
parent and natural guardian of the infant plaintiff, be and hereby is authorized and empowered to execute
and deliver a general release and all other instruments necessary to effectuate the settlement herein; and
it is further
(16) ORDERED, that if it appears that any government agency may attach a lien to the infant’s
payment, this Order may be amended to allow the creation of a Supplemental Needs Trust for the benefit
of the infant and the Supplemental Needs Trust will be substituted as the payee of the payments.
(17) ORDERED, that the filing of a bond be dispensed within accordance with the applicable
provisions of the Civil Practice Law and Rules.
________________________
Hon. Paul A. Victor, J.S.C
Page of 4